Author: Janet C. Currie

Chapter Fourteen

I am a social worker and was, for many years, the director of a consulting company in Victoria BC where I managed over 100 research and policy planning projects for the federal and provincial/territorial governments. The scope of my research included women’s health, criminal and civil justice, the delivery of social services, family violence prevention, addictions and prescription drug use and safety. 

 I continue to coordinate a website on prescription drug safety and was invited to consult with the Canadian Senate, Parliament and Health Canada on off-label prescribing and adverse drug reactions. I was the Chair of the Canadian Women’s Health Network for many years and was a two-term member of Health Canada’s Expert Advisory on the Vigilance of Drug Products.   Currently I am a member of Independent Voices for Safe and Effective drugs, a national drug policy organization, and am on the Core Executive of the Canadian Deprescribing Network, a national initiative that addresses overprescribing among older Canadians. 

My work on prescription drug safety led to my identifying concerns about the safety, effectiveness and transparency of off-label prescribing, a practice that is prevalent and, although allowable, is not regulated by Health Canada.  I have pursued this topic in my doctoral studies at UBC by using a case study of the off-label use of domperidone when it is used to treat low milk supply.  

Chapter Fourteen

I was delighted to provide some background information on the increasing off-label use of domperidone to treat low milk supply for the textbook.  Off-label use means that an approved drug is being used for a purpose for which it has not been approved.  Domperidone has not been approved to treat low milk supply in any jurisdiction.  

My chapter gave me the opportunity to discuss some concerns related to the safety and effectiveness of domperidone and to suggest that more scrutiny be used when off-label prescribing is considered. I am hopeful that my chapter may promote more research on domperidone  and a precautionary approach to using this drug to address early milk supply problems.  

I breastfed my children and it was a wonderful, (although sometimes challenging), experience.  It is exciting to be able to contribute to students and healthcare providers who are helping women and their babies have a fulfilling experience with breastfeeding.